Tramadol and its mechanism of action
Antiepileptic drugs and tricyclic antidepressants are commonly used to treat neuropathic pain. However, the exact mechanism of their action is still unknown. The use of both groups of drugs is limited by their side effects, as it is difficult to achieve the optimal plasma concentration required for pain control without affecting the patient's well-being.
Initially, neuropathic pain was thought to be refractory to opioids. Only recently have opioids been rediscovered as a potential treatment for neuropathy. The mechanism by which classical opioids suppress pain is mediated by mu receptors. Purchase Tramadol Online Receptors of this type are located on the pre- and postsynaptic membranes of primary afferent nerve fibers. Their activation on the presynaptic membrane reduces glutamate release. However, at the postsynaptic membrane, this process causes hypopolarization through increased potassium flux. Although the biochemical details are unclear, it is clear that the sedative effect of tramadol has the mu receptor as the main lever.

Tramadol and doping
In addition to its analgesic effect, tramadol is known as a euphoric drug that improves mood and performance. The combination of analgesic and euphoric properties puts this substance on the doping list. The World Anti-Doping Agency (WADA) reported that tramadol was found in more than 4 percent of urine samples from cyclists and athletes in 2017. Although effective for sports-related injuries, the drug is said to have a significant potential – restorative effect, in itself is a serious reason for the non-competition clause. For reasons unknown, WADA's new doping list for 2019 still does not include tramadol.

For recreational use, health experts strongly recommend against using this drug because of its performance-enhancing properties. Apart from unpleasant side effects like nausea and vomiting, there is also the problem of addiction. Athletes who choose tramadol have the habit of exerting themselves every day and then naturally becoming addicted - this scenario is typical for all opioids. While there are sports organizations such as the World Cycling Union (UCI) that have recognized this problem and defined tramadol as doping, most sports federations continue to address it. For example, tramadol has never been banned from football and FIFA believes that the use of tramadol among football players is very limited and therefore has not taken any official action against it.

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